Manipulator‐driven selection of semi‐active MR‐visible markers

Background

A method for the identification of semi‐active fiducial magnetic resonance (MR) markers is presented based on selectively optically tuning and detuning them.

Methods

Four inductively coupled solenoid coils with photoresistors were connected to light sources. A microcontroller timed the optical tuning/detuning of coils and image collection. The markers were tested on an MR manipulator linking the microcontroller to the manipulator control to visibly select the marker subset according to the actuated joint.

Results

In closed‐loop control, the average and maximum were 0.76° ± 0.41° and 1.18° errors for a rotational joint, and 0.87 mm ± 0.26 mm and 1.13 mm for the prismatic joint.

Conclusions

This technique is suitable for MR‐compatible actuated devices that use semi‐active MR‐compatible markers.     

Evaluation and application of CO2 laser fiber delivery for single port transoral robotic surgery

Background

Transoral robotic surgery (TORS) using the Single-Port system (SPS) relies on electrocautery, limiting its applications in the upper aerodigestive tract. We evaluated the feasibility of a CO₂ delivery system for the SPS.

Methods

Otolaryngology residents performed a cutting exercise using a handheld CO₂ laser and participated in a cadaveric oropharyngeal dissection using the SPS with monopolar cautery (SP + EC) and CO₂ laser (SP + CO₂). Residents completed the System Usability Scale (SUS) questionnaire to evaluate these techniques.

Results

The same laser fiber was used for all combined dissections. The handheld CO₂ laser, SP + EC, and SP + CO₂ demonstrated similar SUS scores. On individual domain scores, SP + CO₂ received less favorable ratings compared to the handheld CO₂ laser for complexity, integration, and cumbersome experience (p < 0.05). On subgroup stratification, less TORS experience was associated with worse SUS scores.

Conclusion

SP-guided CO₂ laser delivery is a viable alternative to electrocautery in robotic surgery, and should be considered when performing TORS.     

Improving pancreas graft utilization through importation

Background

We analyze our outcomes utilizing imported allografts as a strategy to shorten wait list time for pancreas transplantation.

Methods

This is an observational retrospective cohort of 26 recipients who received either a locally procured (n = 16) or an imported pancreas graft (n = 10) at our center between January 2014 and May 2017. Wait list times of this cohort were compared to UNOS Region 9 (New York State and Western Vermont). Hospital financial data were also reviewed to analyze the cost‐effectiveness of this strategy.

Results

Imported pancreas grafts had significantly increased cold ischemia times (CIT) and peak lipase (PL) levels compared to locally procured grafts (CIT 827 vs 497 minutes; P = .001, PL 563 vs 157 u/L; P = .023, respectively). There were no differences in graft or patient survival. The median wait time was significantly lower for simultaneous kidney‐pancreas transplants at our center (518 days, n = 21) compared to Region 9 (1001 days, n = 65) P = .038. Despite financial concerns, the cost of transport for imported grafts was offset by lower standard acquisition costs.

Conclusions

Imported pancreas grafts may be a cost‐effective strategy to increase organ utilization and shorten wait times in regions with longer waiting times.     

Reconstruction Following the Pylorus Preserving Whipple Resection: PJ, HJ, and DJ

Introduction  

Pancreaticoduodenectomy is one of the most challenging procedures performed by general surgeons.     

Mitral paravalvular abscess with left ventriculo-atrial fistula in a patient on dialysis

Background  

Infective endocarditis in hemodialysis patients is challenging but is becoming more common recently.     

Influence of surgical gloves on haptic perception thresholds

Background

Impairment of haptic perception by surgical gloves could reduce requirements on haptic systems for surgery. While grip forces and manipulation capabilities were not impaired in previous studies, no data is available for perception thresholds.

Methods

Absolute and differential thresholds (20 dB above threshold) of 24 subjects were measured for frequencies of 25 and 250 Hz with a Ψ‐method. Effects of wearing a surgical glove, moisture on the contact surface and subject's experience with gloves were incorporated in a full‐factorial experimental design.

Results

Absolute thresholds of 12.8 dB and ?29.6 dB (means for 25 and 250 Hz, respectively) and differential thresholds of ?12.6 dB and ?9.5 dB agree with previous studies. A relevant effect of the frequency on absolute thresholds was found. Comparisons of glove‐ and no‐glove‐conditions did not reveal a significant mean difference.

Conclusions

Wearing a single surgical glove does not affect absolute and differential haptic perception thresholds.     

Spontaneous chylous cardiac tamponade: a case report

Background  

Chylous cardiac tamponade is a rare condition with little known cause.     

The use of a silicone-coated acrylic vaginal stent in McIndoe vaginoplasty and review of the literature concerning silicone-based vaginal stents: a case report

Background  

Mc Indoe vaginoplasty is one of the mostly performed surgical interventions in Mullerian agenesis.     

Transthoracic versus transhiatal esophagectomy for esophageal carcinoma: experience from a single tertiary care institution

Background  

There is a lot of controversy about the best surgical treatment for esophageal carcinoma.     

Open cholecystectomy for all patients in the era of laparoscopic surgery – a prospective cohort study

Background  

Open cholecystectomy through a small incision is an alternative to laparoscopic cholecystectomy.     

Sexual function outcome following photoselective vaporisation of the prostate

Introduction  

There is little reported on sexual functional outcome following photoselective vaporisation of the prostate using the 120 W lithium triborate laser.     

Clinical features and outcomes of 98 children and adults with dense deposit disease

Background  

Dense deposit disease (DDD) is an ultra-rare renal disease.     

Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments

Objective  

The aim of the study is to describe techniques of robot-assisted parenchymal-sparing liver surgery.     

Caroli's Disease: Report of Surgical Options and Long-Term Outcome of Patients Treated in Argentina. Multicenter Study

Background  

Caroli's disease (CD) management is still controversial.     

Acute Giant Gastric Volvulus Causing Cardiac Tamponade

Introduction  

Acute gastric volvulus is an uncommon condition which is rarely associated with cardiac impairment.     

Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia

Background  

Congenital pseudoarthrosis of the tibia (CPT) is one of the most difficult conditions to treat.     

Simple elbow dislocations: a systematic review of the literature

Objective  

To identify if functional treatment is the best available treatment for simple elbow dislocations.     

Scapulothoracic dissociation: a rare injury with scapular comminuted fracture and intact clavicle

Introduction  

Scapulothoracic dissociation is a high-energy injury of the upper limb, often misdiagnosed due to associate traumas.     

Long-term effects of surgical correction of adrenal hyperplasia and adenoma causing primary aldosteronism

Purpose  

The purpose of this is to study long-time results of surgery for primary aldosteronism.     

Clinical Impact of Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma

Background  

The clinical impact of extrapleural pneumonectomy in malignant pleural mesothelioma is poorly investigated.